Otosclerosis and Its Treatment

OTOSCLEROSIS is a disease process which arises in the otic capsule in which the normal bone is replaced by new spongy bone. This process begins most commonly just anterior to the oval window fossa in which the stapes sits. Involvement of the stapes in the disease process reduces its mobility, thus resulting in a conductive deafness. Until the fenestration operation was introduced no surgical treatment could be offered to patients with this disease. The fenestration operation gave some hearing improvement, but it had the disadvantage of leaving a large mastoid cavity, which frequently became infected, and of not restoring the hearing to normality. It was succeeded by the operation of stapedectomy which left no mastoid cavity and did, in many cases, restore the hearing to normal. Several variations in the technique of this operation have been described, all of which result in good hearing improvement. With these advances in surgical technique it is now possible to release many patients with otosclerosis from their handicap of deafness and restore them to useful life in their community.